Director of Cardiac Electrophysiology,Flinders Medical Centre | Head, Cardiac Signals Analysis Lab| Professor of Medicine, Flinders University, Australia
Adelaide
Joined June 2014
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Anand Ganesan retweeted
LBB Area Pacing vs RV Pacing for AV Block and Preserved Left Ventricular Function:
The #LEAP-Block Trial
📍499 patients with #LVEF ≥50% randomized to LBBAP vs #RVP across 14 Chinese hospitals.
📍 Primary endpoint: 2.4% vs 12.5% favoring #LBBAP (P=0.003).
📍 HF events: 3.4% vs 11.3% with LBBAP vs RVP.
📍 LBBAP ⬇️ the 24-month primary endpoint risk (HR 0.37, 95% CI 0.19–0.73), with no significant differences in mortality or device complications.
#LEAPBlock #Cardiology #HeartFailure #Pacing
jamanetwork.com/journals/jam…
@JAMACardio #JAMA
Anand Ganesan retweeted
It is hard to find an indication to implant pacemakers in the RV apex.
LBB Area Pacing vs RV Pacing for AV Block and Preserved Left Ventricular Function:
The #LEAP-Block Trial
📍499 patients with #LVEF ≥50% randomized to LBBAP vs #RVP across 14 Chinese hospitals.
📍 Primary endpoint: 2.4% vs 12.5% favoring #LBBAP (P=0.003).
📍 HF events: 3.4% vs 11.3% with LBBAP vs RVP.
📍 LBBAP ⬇️ the 24-month primary endpoint risk (HR 0.37, 95% CI 0.19–0.73), with no significant differences in mortality or device complications.
#LEAPBlock #Cardiology #HeartFailure #Pacing
jamanetwork.com/journals/jam…
@JAMACardio #JAMA
Anand Ganesan retweeted
On #WorldHeartDay, Chennai Heart Rhythm Trust (CHRT) conducted a cardiac health awareness drive and provided free health check-up packages for Chennai’s sanitary workers.
Deeply heart-warming as a founding member to give back to those who keep our city running every day. ❤️🩺
Heartfelt thanks to Rotarians Prabhakar, Marshall, and Soundararajan (Rotary Mogappair) and CHRT Secretary Renuga for organizing this wonderful initiative!
HeartHealth #CHRT #Chennai #Rotary
Anand Ganesan retweeted
We will unlock true AF mechanisms in the next few years. Maybe sooner.
AF is fundamentally a problem of nonlinear, multiscale dynamics.
The concept of 10k agents swarming together is impossible to imagine.
We’re sharing a solution to the Navier-Stokes Millennium Prize Problem, one of the deepest problems at the frontier of mathematics.
The proof was produced by a group of agents, using an OpenAI next-generation model significantly more capable than GPT-6 Astra.
The problem concerns whether the description of smooth three-dimensional fluid motion modeled by the Navier-Stokes equations can break down. It has remained unresolved for roughly 90 years.
Anand Ganesan retweeted
It’s all just topology.
Topology, topology, topology, topology, Topology, topology, topology, topology, Topology, topology, topology, topology, Topology, topology, topology, topology..
Please don’t forget this. It’s really important.
Double figure-of-eight reentry during atrial tachycardia using 4 critical boundaries: A unique topological finding #OpenAccess
heartrhythmjournal.com/artic…
Anand Ganesan retweeted
Dr. Joseph Selvanayagam and Dr. C. Michael Gibson discuss the CMR GUIDE trial: Scar-guided ICD implantation did not significantly reduce the primary composite endpoint of SCD/HSVA in patients with LVEF 36-50%. Watch video here: clinicaltrialresults.org/wp-…
Anand Ganesan retweeted
CMR GUIDE trial: Scar-guided ICD therapy did not significantly reduce the primary composite of SCD or HSVA in patients with LVEF 36-50%, despite a signal for reduced SCD. View slides here: clinicaltrialresults.org/wp-…
Anand Ganesan retweeted
It has been an immense privilege to lead this trial, and report on it at @escardio congress. All clinical trials are hard, investigator initiated trials even more so. Thank you to all investigators, trial staff, steering committee, DSMB, CEC and DDC members, and most of all patients and families who took part in the trial
🫀 CMR-GUIDE @ #ESCCongress2026, published in JAMA.
353 pts, LVEF 36–50% + #whyCMR scar, randomized to ICD vs loop recorder.
▪️ Primary endpoint neutral: HR 0.76 (0.37–1.66)
▪️ SCD lower with ICD: 1.7% vs 5.8%
▪️ Prespecified subgroup: benefit in patients <70 @SCMRorg
Anand Ganesan retweeted
How low should we go with BP in atrial fibrillation?
Our #ESC2026 study, simultaneously published in @EuropaceEiC , suggests a “sweet spot”:
🔹 SBP ~120–130 mmHg
🔹 Avoid DBP <75–80 mmHg
🔹 Lower is not always better
In AF, both numbers matter.
bit.ly/4yeNyQB
#AtrialFibrillation #Hypertension
@ElnazShmohamadi @melissaemm1 @Elliott_AD @JonathanAriya
Balanced discussion of CMR GUIDE ... there are nuanced signals for clinical practice in this data - that will resonate into thinking about SCD risk prediction tctmd.com/news/scarring-does…
Anand Ganesan retweeted
📊 Research Summary: In patients with left ventricular ejection fraction of 36% to 50% and myocardial scar on #CardiovascularMagneticResonance, implantable cardioverter-defibrillator therapy lowered sudden cardiac death vs an implantable loop recorder, supporting further study of scar-guided device selection. #ESCCongress ja.ma/4hY8PZZ
Anand Ganesan retweeted
💬 Editorial by Sana Al-Khatib, MD, MHS: Current implantable cardioverter-defibrillator recommendations for primary prevention are based on left ventricular ejection fraction of 35% or less, yet many individuals who experience sudden cardiac arrest do not have marked left ventricular dysfunction. Cardiovascular magnetic resonance with late gadolinium enhancement may help identify higher-risk patients with left ventricular ejection fraction >35%, but randomized clinical trial evidence is still needed to guide practice. #ESCCongress ja.ma/46rkWHO
Nuanced message about CMR GUIDE - this was very tough trial to do and execute.
The trial's primary endpoint wasn't positive - but it still has incredibly important signals about decreasing SCD, and role of ICD therapy in younger pts that we as EPs should think about
💬 Editorial by Sana Al-Khatib, MD, MHS: Left ventricular ejection fraction alone may not adequately identify patients at risk of sudden cardiac death, and cardiovascular magnetic resonance may refine risk assessment in those w/ left ventricular ejection fraction >35%.
🔗 ja.ma/4cjTyPw
#ESCCongress @escardio
Anand Ganesan retweeted
🧵 Presented today at #ESCCongress from @JAMA_current and @JAMACardio:
In patients with myocardial scar on #CardiovascularMagneticResonance and left ventricular ejection fraction of 36% to 50%, implantable cardioverter-defibrillator therapy lowered sudden cardiac death vs an implantable loop recorder.
🔗 ja.ma/4r1H7Ox
Anand Ganesan retweeted
🧵 Presented at #ESCCongress:
Among patients with ischemic or nonischemic cardiomyopathy, left ventricular ejection fraction of 36% to 50%, and myocardial scar on #CardiovascularMagneticResonance, implantation of an implantable cardioverter-defibrillator did not significantly reduce sudden cardiac death or hemodynamically significant ventricular arrhythmia vs an implantable loop recorder.
Rates of all-cause mortality, cardiovascular mortality, and heart failure–related hospitalization were also similar between groups.
ja.ma/4xClJl2
@escardio
Really important to have nuanced messaging about these results..
#ESCCongress
#CMRGUIDE at #ESCCongress
Should myocardial SCAR—not just EF—help determine who gets a primary-prevention ICD?
Patients with:
➡️ LVEF 36–50%
➡️ Ischemic or nonischemic cardiomyopathy
➡️ Scar/fibrosis on CMR
Randomized 353 pt, impacted by COVID, 82% Men
⏱️6.3 y
ICD vs implantable loop recorder
Primary Endpoint= SCD or hemodynamically significant ventricular arrhythmia
🌟RESULTS:
Primary: SCD or hemodynamically significant ventricular arrhythmia
➡️ HR 0.76 (95% CI 0.37–1.58), P=.47 ❌
Sudden cardiac death alone:
➡️ HR 0.26 (0.07–0.95), P=.04
All-cause mortality:
➡️ HR 0.91 (0.49–1.71), P=.78
🫀 CMR-guided ICD implantation did not reduce the primary composite endpoint. The reduction in SCD is intriguing, but as a secondary endpoint in a negative trial it should be interpreted cautiously.
CMR scar alone does not yet appear sufficient to expand ICD indications beyond current EF-based criteria.
📄 jamanetwork.com/journals/jam… @JAMA_current
#WhyCMR #CardioTwitter #EPeeps #HeartFailure
Incredible effort by @josephselvacmr to complete this trial - the culmination of more than a decade of effort!
A huge milestone as a contribution to both the CMR and EP field.
Among patients with ischemic or nonischemic cardiomyopathy, left ventricular ejection fraction of 36% to 50%, and myocardial scar on #CardiovascularMagneticResonance, implantation of an implantable cardioverter-defibrillator did not significantly reduce sudden cardiac death or hemodynamically significant ventricular arrhythmia vs an implantable loop recorder. Rates of all-cause mortality, cardiovascular mortality, and heart failure–related hospitalization were also similar between groups. #ESCCongress ja.ma/46rkSI4
CMR GUIDE is key trial for the EP field - gives the first randomized data we have for the LVEF 36-50% population with myocardial scar.
The positive signal in younger pts, reductions in SCD rates are important and nuanced discussions to have with out pts about ICD therapy.
Among patients with ischemic or nonischemic cardiomyopathy, left ventricular ejection fraction of 36% to 50%, and myocardial scar on #CardiovascularMagneticResonance, implantation of an implantable cardioverter-defibrillator did not significantly reduce sudden cardiac death or hemodynamically significant ventricular arrhythmia vs an implantable loop recorder. Rates of all-cause mortality, cardiovascular mortality, and heart failure–related hospitalization were also similar between groups. #ESCCongress ja.ma/4gvoZHO
Totally agree: as an EP associated with the trial CMR GUIDE has real world relevance to the discussions we have patients every day.
Anand Ganesan retweeted
In patients with myocardial scar on #CardiovascularMagneticResonance and left ventricular ejection fraction of 36% to 50%, implantable cardioverter-defibrillator therapy lowered sudden cardiac death vs an implantable loop recorder. #ESCCongress ja.ma/4qMs4rS